Just a reminder! Thanks for visiting us at Shots Hurt Less Blog! This is just a reminder that the information on this site is intended to be for informational purposes only. It should never replace the recommendations of your doctor - check with your doctor if you have any specific questions! We will always honor and protect patient confidentiality, and we ask that you all do the same, if you choose to comment on our posts. Thanks for visiting!

Ear infections are very common in children. For most children who have an occasional infection here or there, antibiotics may be all they need (and many mild infections may actually go away on their own without any antibiotics - for more details about this please see Dr. Brown's prior blog post on ear infections). But other kids, who get one ear infection after another, may need ear tubes (also called tympanostomy tubes).

So which kids need ear tubes? New guidelines were published several months ago to help us determine if your child should see an ear specialist (an otolaryngologist) to discuss ear tubes. We look at a few factors. First, we consider the frequency of ear infections: more than 3 infections in 6 months or more than 4 infections in 12 months. But the new guidelines highlight one additional factor aside from how many infections. The experts only recommend tube placement for kids with frequent ear infections who have fluid that stays behind their ear drum for more than 3 months.

Like most doctors, I spend a lot of time teaching parents how to help their kids feel better while they are sick. I run through the list of things that may be helpful, depending on the age of your child and whatever is ailing them. Tylenol and Motrin for fever or aches and pains, honey for cough, Vick's vapor rub and bulb suctioning (especially my beloved Nose Frida) for nasal congestion and on and on. I often get a surprised smile from a child when I recommend ice cream or a milkshake to soothe a sore throat - especially when I emphatically say "Ice cream for this kiddo. Doctors orders!" But parents sometimes are suprised to hear me encourage dairy while their child is sick.

Turns out, there is a common misbelief that dairy products (milk especially) should not be given to kids when they have a cold or a fever. Some people are worried that the milk increases mucus or phlegm production. Others worry that milk will turn sour or cause an stomachache for someone who has a fever.

But let's set the record straight! There is no scientific or biologic reason to avoid milk when you are sick with a fever or a respiratory illness such as a cold. (Though gastrointestinal or stomach bugs are a slightly different story as we do recommend avoiding milk immediately after vomiting of in some cases of chronic diarrhea).

There’s no question that we have a problem with gun safety in our country. Every time we turn around, there’s another school, mall, or movie theater shooting. Regardless of where you stand politically on the gun control issue, these frequent shootings do not make the world feel safe and certainly do not set a good example for our children. In reality, the deaths we hear about in the news are only a fraction of gun related deaths amongst children in the United States. A study released in Pediatrics this week found that 20 children EVERY DAY are injured by firearms in the United States. Practically one child every hour. That statistic is alarming.

Researchers in this study reviewed hospitalizations of children under age 20 in 2009 – they found that 7,391 children were hospitalized with a firearm related injury and 453 of those children died. Among young children, most injuries were unintentional, whereas, for adolescents, most injuries were from assault. Either way, more than 8 million children have access to guns – in their own homes, their family or friends’ homes, or maybe even at school. Children (and adolescents) are often unaware of the possible dangers of these weapons. They see them as powerful toys, and are often drawn to playing with them.

When I first suggested to my husband that we needed to buy the Nosefrida, he says he nearly fainted. Clearly, he was clearly not sold on the idea. And most parents that I describe it to in clinic have similar first impressions. And yes, I understand that the concept behind the Nosefrida seems gross. But this baby product is so effective that virtually everyone who tries it is easily won over (my husband included). Parents of my patients rave about it. Many have called it a "life saver" or "the best baby product ever."

There is nothing more pitiful than watching a baby struggle to breath. This time of year, with influenza and RSV running wild in our area, many youngsters out there are in the same bind: tons of snot is keeping them from resting (and in some cases making it hard for them to nurse or drink from a bottle). The classic nasal aspirator (the blue bulb suction) doesn't hold a candle to the Nosefrida - even if you use nasal saline drops too. I have found the bulb suction often causes irritation and sometimes even bleeding due to it's shape and how delicate the skin is inside a baby's nose. As a mother, I have been very frustrated by the meager amount of mucus I can remove with it on my own babies. Enter the blessed Nosefrida!

Nosefrida, the Snotsucker, has an ingeniously simple design (developed by a

Happy New Year! Today, as we all consider our new years resolutions, add this one to your list: figure out the weight of your child plus the weight of their car seat.

The reason? Effective next month (February 2014), the National Highway Traffic Safety Administration (NHTSSA) requires that the LATCH system should be used to secure your child's car seat ONLY if the combined weight of the child + the car seat is less than 65 pounds.

LATCH anchors, found in cars built after 2002, are an attacment system for car seats (LATCH stands for Lower Anchors and Tethers for Chidlren). LATCH was designed with the goal of making it easier to install child car seats. And for anyone who hasn't had the pleasure of wrestling a car seat into proper position, I will attest that it can be really, really hard to get those darn things installed without those blessed LATCH anchors.

Unfortunatley, car manufacturers cannot guarantee the strength of the anchors when adding the additional weight of the seat, thus the need to modify the law.

Inevitably, the fun and excitement of the holiday season also brings with it the dread of cold and flu season. Unfortunately, this year is no exception as we’ve started to see lots of flu and RSV just this past week.

RSV (Respiratory Syncytial Virus) is a common upper respiratory virus that causes bronchiolitis, or inflammation of the tiniest airways in the lungs. In older children and adults, it’s usually just a bad cold; however, in infants and younger children, it can be more severe due to the smaller size of their airways. As a result, it can cause a bad cough, wheezing, and difficulty breathing.

Are poinsettia plants poisonous? Is that holly harmful? Is the mistletoe toxic? Unfortunately, it can be tricky to figure out what plants to avoid if you're decorating for the holidays with little ones toddling around (especially if those little ones also enjoy putting things in their mouths).

So let's set the record straight:

Poinsettia plants are NOT poisionous. In fact, a few years ago, a large national poison control study of nearly 23,000 poinsettia exposures reported no significant toxicity of any kind (no illnesses, severe reactions, or deaths). Of course, it's not considered an edible plant and eating too much may give you a mild stomachache, vomiting or diarrhea, but it won’t kill you.

Holly can be VERY harmful. These bright red berries look especially enticing to young children.In most cases, a child can eat 1-2 holly berries (Ilex) without harm, but around 20 berries can cause serious side effects and even death. And although the berries are the part that is most commonly eaten, the bark, leaves, and seeds are also toxic.

Mistletoe may be toxic (depends on which kind and what part is eaten). There are several species of mistletoe. Both the Phoradendron and Viscum species contains a toxin that can cause a whole host of unpleasant symptoms (blurry vision, stomach aches, vomiting and diarrhea, blood pressure changes) and even death. But this seems to be the excpetion rather than the rule. Research shows that most often, ingestion leads to some minor stomach ache (or no symptoms at all). In fact, studies of hundreds of cases of accidental mistletoe ingestion over several years show there were no deaths and only a handful of severe reactions. One study published in 1996 found that only a small fraction of patients showed any symptoms after eating mistetoe and over 3/4 of those who ate 5 or more berries had no symptoms. However, it does seem the berries are the most toxic part of the plant.

Other tips for making your home safe during the holidays:

Decorate with children in mind! Do not put breakable ornaments on the lower branches of a tree.

Keep decorative lights out of reach of small children

Inspect all lights for exposed or frayed wires.

Natural Christmas trees can pose a fire hazard. To minimie the risk - purchase a fresh tree and keep it watered at all times.

Make sure all smoke alarms have batteries and are working.

Purchase age appropriate toys (do not allow a small infant or toddler to play with toys with small parts that could pose a choking hazard). Hint - if a toy is too small to fit inside a standard cardboard toilet paper roll, a infant or toddler may choke on it.

Beware that batteries and magnets can cause severe damage if swallowed (these are often found in toys, greeting cards, small electronics, and watches). If you suspect your child may have swallowed an object that contains a battery or magnet, seek emergent care.

My baby girl, now 9 months old, has started crawling, pulling up, and cruising over the last several weeks. And boy, is she putting our baby-proofing to the test! It seems like almost every time that she pulls up (squealing with delight), she falls or bumps her head on the way back down. So, I am running to the store to buy more gates and locks every few days, but I am also bracing myself for an injury.

Most kids wind up with an injury, a broken bone or a cut needing stitches, at some point. But it can be hard to tell when a cut is bad enough to require closure with stitches (or sutures as we call them in the medical world). Here are a few questions to ask to help you determine if they need a medical evaluation or if a band aid and a little extra TLC will take care of it.

1. Can you clean the wound well yourself? Depending on where your child was at the time of the injury, there may be dirt and rocks or twigs deep in the wound. It's crucial to clean the wound thoroughly to prevent infection and ensure proper healing. At home, the best way to clean the wound is with water, using pressure. You can use the sink or tub (if you have a spray nozzle that can work well). If, however, that isn't an option (or the location of the injury doesn't lend itself to easy cleaning) - seek medical attention!

2. Is your child up to date on his or her Tetanus shot? If your child has a dirty wound or any type of puncture wound (stepping on a nail, splinters, animal bites) and you're not sure when their last tetanus shot was - call us! Tetanus develops when bacteria releases a toxin that attacks a person's nervous system resulting in serious illness (many cases require intensive care and 10% of cases are fatal)! You really don't want to mess with tetanus!

3. Has the wound stopped bleeding? The cut may need stitches (sutures) if your child's wound has not stopped bleeding within 10 minutes while applying pressure (use a clean cloth or gauze pad to hold firm pressure over the wound) or if the bleeding stops temporarily but then re-bleeds frequently (as often happens when the wound is over a joint and bending of the knee or elbow, for example, causes the wound to re-open).

4. Where is the injury? Cuts that are close to the eye, vertical cuts on the cheek or forehead, and cuts that cross the line between the lip and the face (the red border of the lip) often heal badly (very noticeable scar) if left to close on their own.

5. What does the wound look like? Cuts that are large (deep or longer than 1/2 inch), especially if they have ragged or separated edges or are on the face, typically need to be closed with sutures.

If you determine the injury may need to be closed with sutures - seek medical attention right away! The risk of infection increases significantly after 12 hours or so. Some wounds require sutures, while others may be able to be closed with staples (this is a great option for the back of the head) or even fancy super-glue called Dermabond.

One last piece of advice. When I was a resident working shifts in the Pediatric ED, parents would often ask for the "boss" or the plastic surgeon to close a wound. But that request may land you with either an older doctor whose skills are a bit rusty or a plastic surgery resident who's actually done far less suturing than the ED physician. But...if you get the impression that the person pulling on the gloves may not be comfortable closing a wound, certainly speak up! Be respectful - it usually goes over best if you simply ask (rather than demand) whether an injury such as this requires a specialist.And no matter how the wound is closed (sutures, staples, Dermabond) or who does the closure (ER physician or plastic surgeon) - no one can gaurantee a small scar. People heal differently and some people form bigger scars.

When in doubt, have your child examined either at our office or in the ED. You can call and speak with our triage nurses and describe the injury to figure out whether it's something that we can see in clinic or if you should go straight to WFBH Brenner's Pediatric ED.

‘Tis the season for being thankful. As the Thanksgiving season approaches, we begin to think about thankfulness and gratitude - we talk about things that we’re “thankful for” and may contribute to holiday charity projects. I wrote about gratitude at this time last year, but I think it’s important that these actions not just span the holiday season, but instead get incorporated into our everyday lives. Beyond just teaching gratitude, how do you teach your children to be respectful, thoughtful, and considerate? In short, how do you teach them good manners? I love this quote from Emily Post: “Manners are a sensitive awareness of the feelings of others. If you have that awareness, you have good manners, no matter what fork you use.”

You can start to teach manners from an early age, even before your children can speak! To start, be a good role model for your children. Thank them (and others) for doing things that you appreciate. Don’t interrupt. Be thoughtful and courteous to others. Be respectful to your significant other. To your children, your actions may speak louder than your words...and they will catch on quicker than you think!

In addition to being a good role model, there are little things you can do to teach your children awareness and consideration of others. Emily Post’sEtiquette does a great job highlighting these suggestions - check out these excerpts below:

For the child age 1-3:

Communication

Magic words. Among the first words you teach your toddler are the classic magic words Please and Thank you. Children will tell you years later that saying "please" is the first manner they learned.

Greetings. Toddlers may hide behind your knee, but even the shyest can learn to say a clear "hello" with a smile. This skill takes practice, so help them along.

Conversation. Read books, go to different places, watch television together, and listen to music. Then talk about what you've just done together. Even if they have a small vocabulary, toddlers can respond to things you hold in common especially as they approach three year olds.

Table Manners

The children in this age group can manage a meal lasting twenty or so minutes.

- While they're at the table with you, be sure to include them in the conversation.

- Give them soft foods they can manage with a spoon.

- Bibs are still their napkins.

- Food is for eating. Throwing or playing with food is a definite cue that they've reacher their limit and you need to end their meal. Be firm, and help them leave the table. They can still play in the same room.

Out and About

- During visits to the doctor or dentist for their checkups, children learn to wait. Read them a book or play a quiet game to show them strategies for waiting.

- Demonstrate courteous behavior with service people everywhere. Children learn by watching you.

- In the car, never negotiate when safety is at stake.

- Be firm about car seats.

- Keep a small bag of activities that your toddler can do while riding in a car.

Kids in this age group are developing manual dexterity and confidence as they take on increasingly complex skills. They interact with peers and adults in structured play groups or daycare.

Communication

Magic words. This is the time children begin to "write" their own thank-you notes: A child tells his parent what he likes about the gift, the parent writes the short thank-you note, and the child adds a drawing or "Signs" his name. Children this age can also be expected to say "thank you." They'll need reminding often, but don't give up. By the time they're four or five, they can also add "excuse me" and "you're welcome" to their list of magic words.

Conversation. At this age children are learning the fundamental skills of good conversation. You can help by reminding them to:

- Speak slowly and clearly.

- Not interrupt unless it's an emergency.

- Take turns talking.

Phones. While some three-five-year-olds have a difficult time on the phone, it's time for them to try at least a simple hello. At first it's helpful if the person on the other end is someone they see and speak to often - Dad or Grandma, for example. When they are only three or four, kids may simply look at the phone and refuse to say anything. Encourage them to say hello but if they don't, gently take back the phone and try again another time.

Table Manners

This is a building time - a perfect time to teach manners at the table. Children this age can:

- Add forks to their repertoire of eating utensils.

- Put napkins on their laps (definitely by the time they are five).

- Chew with their mouths closed.

- Participate in table conversations, so be sure to include them.

- Ask to be excused when finished eating, especially if others plan to stay longer at the table.

- Help with simple table setting and clearing.

Out and About

At this age children are with you throughout the day as you do your errands and daily activities.

- Encourage them to help load the grocery cart and unload small bags at home.

- This is a time to reinforce basic manners with service people in a variety of venues - shops, restaurants, banks or post office - and with people who provide service to you at home.

When out and about, you can help your child learn from what he observes. Point out and talk about examples of good manners and bad behavior. "That lady was so nice to the checkout person when she said "Thank you" or (out of earshot) "Did you notice how that man let the door slam on the woman behind him?

I think anyone would say that it is pleasant to be around a well-mannered person, both as an adult and a child. When manners are learned early, they become a habit and a lifelong skill. Manners aren’t taught overnight, however, so it is important to start early, be consistent, and praise your child for treating others kindly.

This morning, while on a walk with my two young kids, I paused to appreciate the cool, crisp autumn air and the hint of yellow in the trees in my neighborhood. I love the fall! There's so much to do from riding the ferris wheel at the Dixie Classic Fair, visiting a pumpkin patch, raking leaves, or choosing Halloween costumes. But, we at Twin City Peds, think there is one thing that should be at the top of your To Do list....Get your children vaccinated against Flu!

I know there are many of you out there that think a flu vaccine isn't essential. It is! Pardon me for being so blunt, but there are many, many very intelligent and well educated people who are misinformed about influenza.

Please allow me to address some of the most popular reasons offered for refusing the flu vaccine.

1. The flu is annoying, but not actually dangerous for an otherwise healthy person (or child).

False. I understand that people who have not worked in a pediatric Intensive Care Unit may have a hard time

Usually we think of cancer as something that happens to adults... but testicular cancer is the most common form of cancer in young men ages 15-35 years old.

And the good news is that it’s also highly curable, especially when it’s caught early. That’s why it’s so important that boys learn how to perform testicular self-exams (TSE) and do them regularly.

Here's how:

1. Do the exam once a month, after a warm bath or shower when the scrotal skin is most relaxed.

2. Roll each testicle gently between the thumb and first two fingers of both hands. The testicles should be smooth, with the consistency of a hard-boiled egg without the shell.

3. Feel for the small, comma-shaped cord, about the size of a pea, that is attached at the back of each testicle. This is a natural part of your testicles, and is called the epididymis. Learn what it feels like, so

This past week in clinic I saw several young children with Croup. Their stories are all very similar - a day or two of runny nose, maybe a fever, and then they come to clinic after a long night of helping their child who is struggling with a barky cough and trouble breathing.

Croup is a viral illness causing swelling of the voice box (larynx) and windpipe (trachea) Parainfluenza virus is the most common cause of croup, but other viruses can cause it as well. The classic barky (or seal like bark) cough and trouble breathing comes from that welling in the back of the throat. Many children also have hoarseness and, in severe cases, some kids develop a high pitched sound when they breathe in which we call "stridor".

What are the symptoms of Croup?

The first symptoms of croup are similar to that of a common cold such as stuffy nose and fever.

The fever is usually between 100.4-104

After 1-2 days of cold symptoms, the classic barky cough develops (heard at the beginning of this video clip, also you hear the "stridor" around 50 seconds into this clip and the child shows signs of trouble breathing - sucking in between the ribs and flaring out nostrils, etc).

The cough is usually worse at night and peaks on night 2 or 3 (then improves gradually)

Many children also have a hoarse voice because of the inflammation of the larynx and vocal cords

Stridor is a harsh and raspy sound when the child breathes in and signals increased swelling in the back of the throat - which requires prompt attention! (See below)

How can I treat Croup?

Since croup is a viral infection, antibiotics are of no help.

If your child wakes up at night with this barking cough and if you hear stridor (see video clip) moisture is key to decreasing the swelling. The temperature doesn't matter so either taking your child outside (thankfully nights in North Carolina are humid) or sit with your child in a warm steamy bathroom (while running a hot shower) After about 10-15 minutes of exposure to steam/humidity, your child’s airway should become less inflamed and more clear. If they aren't improving - seek emergency treatment at WFBH Brenner Children's Hospital (your child may need a special treatment of aerosolized epinephrine that is only available in the Emergency Department).

A cool mist humidifier in your child’s room will also help her breathe easier at night.

Be sure to treat your child’s fever with a fever reducer. This will make her a lot more comfortable and ease their breathing some as well.

Continue to offer clear liquids throughout the day to avoid dehydration

Do not use cough syrups or antihistamines. They do not help children with croup.

When to call the Doctor

Your child has stridor (the harsh and raspy sound made by taking a breath).

Your child is having difficulty breathing (sucking in between their ribs or above their collar bone with each breath or flaring out the nostrils)

Your child cannot talk because she cannot catch her breath

Your child appears very ill and sleepy

Your child has a pale or bluish discoloration around her mouth

Your child’s croupy cough does not seem to be getting better after the 3rd day

Whenever in doubt, call your child’s doctor.

Most cases of croup are mild. Your child may return to school or daycare once the fever has resolved and your child is ready to participate in his daily activities. The best prevention for croup is diligent hand washing since croup is spread just like the common cold: droplet transmission (coughing and sneezing near others) and person to person contact (dirty hands).

I’ve been a mom for eight weeks. In a lot of ways, the past eight weeks have been like my pediatric residency – I’m sleep deprived, not always wearing clean clothes, eating cereal around the clock, and I’m learning more every day about taking care of babies. In fact, I’ve jokingly referred to parenthood as my “pediatric fellowship,” as the all-encompassing experience of keeping a child alive outside of the office or hospital is quite different and is quickly expanding my horizons!

I’ve been asked over and over again what it’s like to be a new parent, while also being a pediatrician. The answer? It’s mostly fun and exciting, but is also mixed in with normal moments of anxiety and feelings of helplessness – especially when I realize that an 8 lb munchkin is pretty much in charge! It’s true that babies don’t come out with an instruction manual (mine certainly didn’t), thus, the most valuable lessons I’ve learned are to trust your gut and go with the flow.

We had a big milestone at the Brown house last week - our baby girl got her first taste of solid foods. Like most little ones faced with their first experience eating something other than breastmilk or formula - her reaction was priceless (some truly hilarious facial expressions). We are all asked for advice about how to introduce solid foods on a daily basis in clinic. And while experts recommend introducing solid foods around 6 months of age... a lot of the guidelines for what to give and when to give it have changed recently based on new research.

First, consider starting solids at a time when your baby is hungry but not starving, such as after he has had a little formula or breast milk, but not after a full milk feeding when he is not at all hungry. Try to introduce new foods with enthusiasm, but do not force your child to eat something. If your child is not interested in a new food, put it away and try introducing it again later.

Start with infant cereal, fruits, or veggies. For most babies it does not matter what the first solid foods are. Traditionally, pediatricians have recommended starting with one of the single-grain cereals (rice, oat, whole wheat, or barley cereal). However, there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby. Others may encourage you to start vegetables before fruits, but there is no evidence that your baby will develop a dislike for vegetables if fruit is given first. Babies are born with a preference for sweets, and the order of introducing foods does not change this.

To make your baby’s cereal:Take 1-2 tablespoons of cereal and put it in a cup or bowl, add formula or pumped breast milk, and make it very soupy (thinner than applesauce)

To feed your baby solids: Put your baby in a bouncy seat (a Bumbo seats work well too). Using a spoon, drip "the soupy-cereal mix” or fruit or veggie on the back half of your baby's tongue so that it will go down his throat!

Good choices for first fruits and veggies include the following (in pureed form):

Babies notoriously have fussy times of day - often in the evening or middle of the night, which can be very difficult to deal with at times! Given that I'm experiencing this with my own one month old right now, I thought it might be helpful to share some tips and tricks for getting your little one to settle down. Specifically, the 5 S's (Swaddle, Side lying, Shush, Sway, and Suck) are very helpful, which were initially introduced in Dr. Harvey Karp's The Happiest Baby on the Block. Welcome to our first attempt at video blogging - hope you enjoy!

I love to take my toddler to the playground. We all get some fresh air while he runs around like a wild man (and, if I'm lucky, he gets worn out so he'll take an extra long nap that day).

Some playgrounds have super steep slides that seem a little too fast for him, though. The solution, I thought, was to climb up on there myself and slide with him (sitting him on my lap). That way I'm there to make sure he doesn't get scared or fall off the end of the slide too fast, etc. Problem solved, right? Wrong!

I just learned about "Sliding Board Fractures" and I want to get the word out to all of you!

Over the last few years, pediatric orthopedists around the country have noted a growing number of toddlers with broken legs (fractured tibias to be exact) and one guy, Dr. John Gaffney in NY started reviewing these kids' medical records to try to pinpoint the problem. He discovered that many of them had been sliding on an adult or older child's lap when the fracture occurred.

"If a toddler is riding by himself and gets his leg stuck against the side of the slide, he can stop himself pretty easily," Dr. Gaffney explained to MSNBC. "But with the parent's weight added in, you've got greater velocity and momentum and it's

Warts are caused by touching frogs, right? As a kid, I would always have that old wives tale in the back of my head as I ran around during the summer catching frogs (yes, I was a tomboy), worried that I would end up with warts because of it. Word to the wise: though most kids may have warts show up at some point during childhood, I can assure you that they aren’t from frog catching!

In reality, warts are caused by viruses (usually Human Papilloma Virus) and are incredibly common among kids. They’re spread by direct contact with contaminated skin, and studies have recently shown that they’re more commonly spread amongst family members and in school classrooms than in public places like swimming pools. Like any virus, the body’s immune system ultimately recognizes it and starts to fight it off, but it can be a very slow process that may take months to years. For that reason, many people seek treatment for warts, as they can tend to be rather unsightly and can also potentially spread to others.

Eczema, also known as the “itch that rashes,” is an extremely common skin condition among children and adults. The fancy medical term for eczema is atopic dermatitis, and both terms refer to chronic inflammation of the skin that causes a red, scaly, itchy rash and can be a real nuisance! Eczema can affect anywhere on the skin, but is most commonly seen in the elbows, behind the knees, and on the face. It can affect people of all ages, but frequently shows up in childhood. Some children do outgrow it with time, while others may continue to experience flares intermittently. Unfortunately there’s not a “cure” for eczema, but rather tons of different management strategies – both for calming down those itchy flares as well as preventing them from happening in the first place!

Preventing Eczema Flares

The #1 rule when it comes to eczema management (and preventing eczema flares) is MOISTURIZE, MOISTURIZE, MOISTURIZE! Seriously, you can’t moisturize too frequently (and honestly, most people probably don’t moisturize enough). You may hear different opinions on how often to bathe children with eczema, but a bath every day actually helps soften the skin and provide some hydration. Make baths short and use warm (but not hot) water. Also be sure to use an unscented soap (like Dove) or hypoallergenic soap (like Aveeno). I love to suggest the “backwards bath,” where you let them play in plain water at first and then soap them up and rinse them off quickly before getting them out of the tub (keeps them from sitting in the soapy water). Once they’re out of the tub, just pat them dry with a towel to keep the skin damp, then apply any medicated ointment your doctor has recommended followed by a thick coat of your moisturizer of choice.

Happy Summer! Summertime is a time for running through the grass with bare feet, sipping lemonade and eating watermelon on the front porch, swimming all day long, bubbles and side walk chalk and bicycles and slip and slides...But all this outdoor play provides ample opportunity for ticks to find their way onto our little ones arms and legs.

Why do we care? Because ticks carry diseases such as Rocky Mountain Spotted Fever (RMSF is common in NC) and Lyme Disease (which is more common in the Northeast) among others.

Tip 1: Every night at bedtime, be sure to do a "tick check" and look over their body for any ticks (be sure to look in socks, in waistbands, at the collar, and on the scalp).

Please note that a tick must be on the body for 36-48 hours to pass any illness to humans. Thus, a tick check with prompt tick removal is an essential component of disease prevention.